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Ron Put

Blood Panel: What to Test Annually?

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Huh, Ron, that's very interesting - I just checked my numbers, and my latest test from the end of May, the MPV is "flagged" as being outside of the range, although the range is different from what your lab is showing. My lab is UCLA and the range is 9.3 - 13.0 fL 

The lab is:

Lab
RONALD REAGAN UCLA MC CLINICAL LABORATORY
757 Westwood Plaza
Los Angeles CA 90095
Tel: 310-267-8100
Lab Director: Alyssa Ziman, MD

and FWIW, they have had the same range for a very long time (looking through my records). Now, my last test came flagged as outside of range at 13.1 which is just outside of the upper limit of 13.0. However, looking through the years, it looks like I'm consistently at 13.0 (i.e. right at the upper limit), except for 2016, where I'm a LOT more outside of the range at 13.8.

Very interesting. I never paid much attention to this, so thanks for that, Ron. 

Edited by TomBAvoider

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On 8/7/2020 at 11:54 AM, TomBAvoider said:

Huh, Ron, that's very interesting - I just checked my numbers, and my latest test from the end of May, the MPV is "flagged" as being outside of the range, although the range is different from what your lab is showing. My lab is UCLA and the range is 9.3 - 13.0 fL ...

The lab which did mine this time is Westpac Labs (I was testing amylase isoenzymes and they do it, so I tested MPV too).

Their range is 7.4-11.9.  My doctor said to ignore it, it is not significant in my case.  But I do wonder if CR or intermittent fasting increases it in healthy people?

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I was looking at some new blood panel results and today being Sunday and all, decided to explore how important the various types of white blood cells are.

Interesting and I would suggest that at some point those are all checked, to establish a baseline and see if there are any issues.

It seems that the various ratios of significant importance.  For instance, the neutrophil/lymphocyte appears to predict mortality under various circumstances, including viral and bacterial infections.  In many, the ratio increases with age.  Here are a couple of examples:

Inflammation biomarkers in blood as mortality predictors in community-acquired pneumonia admitted patients: Importance of comparison with neutrophil count percentage or neutrophil-lymphocyte ratio

 

Neutrophil-to-lymphocyte ratio as an independent risk factor for mortality in hospitalized patients with COVID-19

 

 

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On 8/10/2020 at 10:49 PM, Ron Put said:

The lab which did mine this time is Westpac Labs (I was testing amylase isoenzymes and they do it, so I tested MPV too).

Their range is 7.4-11.9.  My doctor said to ignore it, it is not significant in my case.  But I do wonder if CR or intermittent fasting increases it in healthy people?

MPV: my lab gives a normality range of 7.4-10.4 fL

My recent value is 7.6, almost on the lower bound of the normality range.

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Four biomarkers of endogenous cardioprotective molecules include N-terminal pro-B-type natriuretic peptide (NT-proBNP, neurohormonal activity), erythropoietin (erythropoiesis and hypoxic response mediated by hypoxia-inducible factor-1 (HIF1)), adiponectin (insulin-sensitizing and anti-inflammatory pathway), and extracellular superoxide dismutase (EC-SOD or SOD3, antioxidant enzyme in the arterial wall). B-type natriuretic peptide, a bioactive counterpart of NT-proBNP, causes natriuresis and diuresis, arterial dilatation, and antagonism of the renin–angiotensin–aldosterone system, thus counter-regulating hemodynamic abnormalities in heart failure21. All of these cardioprotective biomarkers are upregulated in elderly patients with heart failure17,18,19,20. Three inflammatory mediators include interleukin-6, tumor necrosis factor-alpha (TNF-alpha), and angiopoietin-like protein 2 (Angptl2). Angptl2 is upregulated in obesity and type 2 diabetes and accelerates endothelial inflammation, atherosclerosis, and the pathogenesis of heart failure22,23. Finally, reduced reserve capacity of multiple organ systems is involved in heart failure in old age24; hence, the levels of two biomarkers, cystatin C and cholinesterase, are measured as indicators of the functional reserves of the kidney and liver, respectively25,26. Cystatin C is selected because it shows a much higher correlation with age than does creatinine in approximately 5000 healthy individuals ranging from 25 to 110 years27. These nine candidate biomarkers are assessed for associations with survival in multiple cohorts of centenarians, (semi)-supercentenarians, and very old individuals, compared with traditional cardiovascular risk factors and plasma albumin, which are independent predictors of mortality in older adults28. First, we show an age-related increase in cardioprotective and inflammatory biomarkers, and a decrease in organ reserves up to 115 years of age. Of these, four biomarkers including NT-proBNP, interleukin-6, cystatin C, and cholinesterase are associated with all-cause mortality at the oldest old. Finally, only the relationship between NT-proBNP and all-cause mortality is robust against adjustment for traditional risk factors, inflammation, and organ reserve.

 

 

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I am curious if someone has had, or has researched the PULS Cardiac Test, which supposedly evaluates and identifies asymptomatic heart disease based on a limited set of blood biomarkers?

Here is an excerpt from a case study:

"This image is a coronary computed tomography angiography (CCTA) and plaque activity characterization of a 46-year-old white male with a normal stress test, a positive family history, and metabolic syndrome (low high-density lipoprotein [HDL], borderline low-density lipoprotein [LDL] and total cholesterol). The image can be used to study plaque morphology, function, and risk of rupture. Plaque activity was measuring nine serum proteins (CTACK, eotaxin, MCP-3, IL-16, HGF, sFas, Fas ligand, hemoglobin A1c, and HDL). The patient was shown to have significantly elevated risk of a heart attack (acute coronary syndrome) at 8.07% (absolute risk) within 5 years. This score corresponds to a 5.34-fold higher relative risk for acute coronary syndrome than expected for the patient's age and sex. Vulnerable plaque characteristics can be assessed both quantitatively and qualitatively, and their impact on coronary flow limitation can be determined by CCTA. These features have been shown to strongly correlate with invasive coronary angiography and are predictive of future acute coronary events."

Here is a link to the description on the PULS site:


https://pulstest.com/news/puls-cardiac-test-performance-data-measuring-endothelial-injury-to-predict-acute-coronary-syndrome-to-be-presented-at-2017-american-heart-association-scientific-sessions

Edited by Ron Put
Adding a link to the PULS site

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On 6/5/2020 at 3:57 PM, Ron Put said:

Well, it appears that nobody here seems to have a good, comprehensive list.  The various threads on the subject are old and peppered with longwinded arguments, and thus not particularly helpful to someone looking for a quick guide.

I am posting what I came up with, mostly based on Ben Greenfield's list for males, plus additional items I believe might be useful to test as a baseline.

The list is personal and since I am a male, it does not include items specific to female health. Those looking for female-specific biomarkers to add should check out the links in the posts above.

Not every item would need to be tested every year, but I am satisfied with it, overall.  Note that I have omitted the more granular thyroid tests Greenfield suggests, other than TSH, mainly because I already have established a baseline for myself and because the basics are covered in most regular blood tests.  For many, this may be total overkill and a waste of money, but I personally am curious to know. 

So, for those interested, here is my list for this year.  If I missed anything significant, please chime in and I will update this post as necessary.

25-Hydroxy-Vitamin D

Adiponectin

Apolipoprotein A-1

Apolipoprotein B

CA 19-9

CEA

Cardio IQ Lipoprotein Fractionation, Ion Mobility

Complete Blood Count with Differential ( include RCDW calculation)

Complete Metabolic Panel

Copper

Cortisol

Cyanide (if you eat a lot of almonds, flax, etc.)

Dehydroepiandrosterone Sulfate

Estradiol

Erythrocyte Zinc Protoporphyrin

Ferritin, serum

Fibrinogen

Folate

Free Fatty Acids

Hemoglobin A1c

Homocysteine

High-sensitivity C-reactive protein

IGF-1 (Growth hormone surrogate)

IGF bonding protein 3

Iodine (if you don't use enriched salt)

Insulin

Iron, TIBC

Lipid Panel with Particle Size

Lipoprotein (a)

Lipoprotein-associated Phospholipase A2

Luteininzing Hormone

Methylmalonic Acid ( MMA)

Omega 3 Fatty Acids

PHI

PTH

RBC Magnesium

Selenium

SHBG (sex hormone binding globulin)

Testosterone + Free Testosterone

Thiamine

TSH

Uric Acid

Vitamin A

Vitamin B12

Your list is more comprehensive than mine (https://www.longevityadvice.com/aging-biomarkers/). Although, any reason you don't have Coronary artery calcium (CAC) score in there? Or liver markers like ALT and AST? Also may be worth considering a genome sequence to check for specific mutations like APOE if you haven't already.

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Thank you for the suggestions. I'll add the calcium scan, it appears very useful if issues are suspected.

As to genetic testing, I've done Nebula Genomics (30x whole) and 23andme.

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Thanks, Mike, I enjoy your videos.

But have you tested IL-6 in addition to CRP, and if not, is it because of the considerable correlation?

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Test nothing.

Don’t take any supplements.

And if things looked ok in the last 10 years.....don’t test again.

By testing you have the possibility of being medicalized and rather than being helped you might be harmed, IMO obviously.

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1 hour ago, DHL said:

Test nothing.

Don’t take any supplements.

And if things looked ok in the last 10 years.....don’t test again.

By testing you have the possibility of being medicalized and rather than being helped you might be harmed, IMO obviously.

Cover up your "check engine" warning light.

Never add oil.

If your car has been running for 10 years....keep going.

By testing you have the possibility of overpaying for unneeded maintenance and repairs.

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On 5/3/2021 at 8:11 AM, Todd Allen said:

Cover up your "check engine" warning light.

Never add oil.

If your car has been running for 10 years....keep going.

By testing you have the possibility of overpaying for unneeded maintenance and repairs.

I agree with this.

Lifestyle and dietary changes have an effect on blood markers and to me, it seems prudent to identify patterns that may be actionable.

On the subject of IL-6, here is a study that exposes some differences from CRP:

Association of Circulating C-Reactive Protein and Interleukin-6 with Longevity into the 80s and 90s: The Rancho Bernardo Study

Conclusions: Higher levels of inflammatory markers predicted reduced survival time and shorter lifespan among older men, whereas only IL-6 was associated with longevity in postmenopausal women and only among those not using estrogen.

 

Edited by Ron Put

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Can Blood-Circulating Factors Unveil and Delay Your Biological Aging? (Dec. 2020)

Quote

In this article, we present an overview of the latest research on the most significant reporters of aging. These are metabolic, hormonal, and inflammatory factors which provide objective criteria of biological age. Moreover, some of these factors directly affect the process of aging. In this review, we will focus only on the factors that can be measured in blood plasma.

 

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On 5/3/2021 at 11:11 AM, Todd Allen said:

Cover up your "check engine" warning light.

Never add oil.

If your car has been running for 10 years....keep going.

By testing you have the possibility of overpaying for unneeded maintenance and repairs.

People are infinitely more complex than a car.

People self repair.

People aren’t cars.

Not saying if you have a problem not to be seen.

You can do all the blood checking you want. You can supplement with anything you want.

Odds are if your diet isn’t to wacky that any supplementation will probably do more harm than good.

Most probably if you aren’t dead by 87 years old, then you are headed in that direction no matter what you do.

How old is the oldest person on this board ? That guy Saul ? I postulate that nothing he does associated with any of these health interventions encouraged by most members here did nothing to contribute to his longevity and possibly was detrimental.

But what do I know ? 

 

 

 

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22 hours ago, DHL said:

I postulate that nothing he does associated with any of these health interventions encouraged by most members here did nothing to contribute to his longevity and possibly was detrimental.

But what do I know ? 

Good question, DHL. How old are you?

You seem to have a rather nihilistic view, at least on the subject of nutrition and exercise. I am not sure I'd consider it very productive, or thoughtful. Sure, we don't have all the answers, but then science and knowledge never do. But only the very dim throw their hands up and proclaim that there is no point in trying to gain more knowledge, and I see nothing in your posts that would indicate a reasoned argument against the various views expressed here, only a consistent rejection.

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23 hours ago, DHL said:

Odds are if your diet isn’t to wacky that any supplementation will probably do more harm than good.

I'm not a fan of blind untargeted supplements such as a daily multi-vitamin and mineral.  But food fortification and enrichment programs have scored impressive public health wins reducing scourges such as pellagra, beriberi, goiter, rickets, anemia, and spina bifida.   Hardly anyone argues enrichment and fortification are optimal strategies.  For example grain products are commonly enriched with iron reducing problems of iron deficiency such as anemia but yet a significant number of people are prone to excess iron such as hereditary haemochromatosis.  We can do better with testing and targeted interventions including supplementation to address challenging deficiencies.

23 hours ago, DHL said:

How old is the oldest person on this board ? That guy Saul ? I postulate that nothing he does associated with any of these health interventions encouraged by most members here did nothing to contribute to his longevity and possibly was detrimental.

If ones standard of comparison is perfection then surely we are all engaged in detrimental health interventions.  But considering the prevalence of chronic diseases of advancing age one could also argue that most everyone here including Saul is doing significantly better than average.

I used to doubt the value of testing and supplementation and I suffered for it.  Many years ago my neurologist upon learning I was vegan tested my B12 status and found I was acutely deficient.  B12 injections produced rapid profound improvements in well being.  Testing also found vitamin D insufficiency which I've since managed through intentional sun exposure and supplementation.  I didn't notice significant benefits from addressing my vitamin D status but things may have gone worse if it wasn't caught.  Five years ago finger prick blood glucose testing revealed extreme post prandial glucose swings which were easily fixed with awareness of the issue to which I attribute many benefits although it is difficult to be certain about those which developed gradually .  About a year and a half ago testing revealed I had very severe lead poisoning.  We only found modest sources of lead exposure many of which we have yet to address, but I have rapidly achieved "normal" levels of lead in blood and urine through extensive testing, supplementation and medication with major improvements of all my symptoms of lead poisoning.  I regret my delays in embracing proactive approaches to identifying and managing my issues of nutrition and health.

Edited by Todd Allen

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I’m mid 50’s a bit of a mutant. I guess we all are. 
I found out years because I had a disabled child, that has passed away a bunch of years ago, that I carry a translocation in my chromosomes that while I look typical has given me slightly usual skin. Basically I’m not as strong as most but I might look somewhat younger than I am. With what seems to me a normal to hyperactive immune system to bad colds and flu......meaning while my immune system works decently when attacked......it makes me pretty miserable.

and Todd no disrespect, but I kinda classify a Vegan diet as over the top.

My guess and it’s only a guess mild you, is that optimal health is achieved  if you eat ok, no extremes in diet one way or the other. I figure if you feel good and you aren’t too fat then keep doing what you are doing. I don’t think any special supplementation or wacky diet, like a vegan diet, is necessarily that healthy.

I don’t want to start an inner exploration with what is wrong with me by testing my blood. Last time I got tested was 7 years ago  for insurance and that was enough for me.

We are all going to get sick and die eventually, there just isn’t any real evidence that any special interventions are going to change that one way or the other in my opinion. However needless intervention one way or another just might speed up the sick and dying part.

Again all in my opinion only, and not meaning to be argumentative. Just expressing another opinion, which I realize I might be kind of alone with here.

 

 

 

 

 

Edited by DHL

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Also I’m sure most people are doing significantly better than average here. But I don’t think it’s because of what you are doing, but rather in spite of it. Not that all of it is bad, it’s just not all good either.

There is also some self selection bias here being that most people on this board may have been reasonably healthy to begin with (I’m guessing ).  So are they better than average because of the somewhat extreme or unusual preoccupation with diet, supplementation, checking on ones blood, or are they better than average in spite of that.

Not sure. Hey I might die tomorrow.  I hope not. But I might. I will die one day though. 

Edited by DHL

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12 hours ago, DHL said:

no disrespect, but I kinda classify a Vegan diet as over the top.

...

Again all in my opinion only, and not meaning to be argumentative. Just expressing another opinion, which I realize I might be kind of alone with here.

...

So are they better than average because of the somewhat extreme or unusual preoccupation with diet, supplementation, checking on ones blood, or are they better than average in spite of that.

I also consider a vegan diet extreme although I don't think extremism is inherently bad or balance and moderation are inherently good.  I think people should pursue whatever works for their goals.  We can get into trouble pursuing extremism through love of ideology (and bad science) but extremism through love of results helps achieve goals.  I think your concerns are valid but you might be going too far in fearing mistakes even though most of us take various things to counter productive extremes.  But we do better caring about health and longevity and being more invested in pursuing our goals so long as our gains outweigh the costs of mistakes.

I have minimized or avoided common pitfalls of over eating, sedentary behavior, excess stress, poor sleep and addictions such as smoking, alcohol and pain killers and am ok making mistakes in taking other things too far in pursuit of optimization.   It is good to learn from others mistakes but I do better developing skills in complex tasks with trial and error.   I have sufficient health to handle moderate mistakes and hope by paying attention to catch them early.  I desire longevity but my focus is on health span and a genetic muscle wasting disease makes physical fitness my primary concern.  Physical performance is tangible and trackable and is the first yardstick by which I measure and evaluate efforts towards health and longevity.  But it isn't sensitive or specific and with an inability to test lifestyle choices in isolation I want additional metrics.  I've found value in blood labs and medical testing despite cost and believe potential downsides such as risk of over medicalization are manageable when one is an active participant in the selection and interpretation of tests.  If I had unlimited funds I would do much more medical testing.  I think the ultimate would be to buy test equipment and set up a home lab so I could test other things similar to how I can test my blood glucose and track responses to diet, exercise and anything else possibly relevant. 

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On 5/11/2021 at 7:59 PM, DHL said:

So are they better than average because of the somewhat extreme or unusual preoccupation with diet, supplementation, checking on ones blood, or are they better than average in spite of that.

Well, some have a preoccupation with spectator sports or tweaking their cars, or wine and gourmet food, or religion, or politics.

I don't know what "extreme" means to you, but I'd say adherence to certain rules generally accepted as healthy is not extreme. And it's probably ultimately better to have a preoccupation with one's health than with any of the items on the list above.

It's like a hobby. I visit here to learn, and I try to share what I have learned. You don't have to accept any of it, although if you truly believe it to be so senseless, I do wonder why do you bother reading any of it. But I don't believe anyone here has set out to convert anyone else.

I am puzzled that anyone would oppose gaining more knowledge, about anything really. Tests, including a blood panel, can show problems. Some of these problems may be remediable before they become life-threatening, or life-changing. For tweakers like some here, tests also provide information about the possible effects of certain lifestyle changes. I see nothing wrong with it.

The main goal for many is healthspan. Lifespan is another matter and it's debatable what, if anything, extends it. But at least one can die trying, right.

BTW, not everyone, or even the majority is vegan. And I personally don't think it's "extreme" in any way. Frankly, to me obesity is extreme. Or obsessing if one's wine is from the right parcel, year, or at the perfect temperature. Different people, different strokes.

I am vegan for moral reasons, not health ones. To me, the word is perceived by each sentient creature only while there is sentience to perceive it. Thus there is a world that is "unique" to each sentient person or animal, and it begins and ends with such an individual. I simply decided that I did not want the world of an animal to be snuffed out because of me.

Any health benefits (and I am convinced that there are such) from being a vegan stem from that decision. But I don't have to, and wouldn't eat animals, even if it was proven to be healthy.

OK, this is it for my rant.

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On 5/14/2021 at 8:39 PM, Ron Put said:

Well, some have a preoccupation with spectator sports or tweaking their cars, or wine and gourmet food, or religion, or politics.

I don't know what "extreme" means to you, but I'd say adherence to certain rules generally accepted as healthy is not extreme. And it's probably ultimately better to have a preoccupation with one's health than with any of the items on the list above.

It's like a hobby. I visit here to learn, and I try to share what I have learned. You don't have to accept any of it, although if you truly believe it to be so senseless, I do wonder why do you bother reading any of it. But I don't believe anyone here has set out to convert anyone else.

I am puzzled that anyone would oppose gaining more knowledge, about anything really. Tests, including a blood panel, can show problems. Some of these problems may be remediable before they become life-threatening, or life-changing. For tweakers like some here, tests also provide information about the possible effects of certain lifestyle changes. I see nothing wrong with it.

The main goal for many is healthspan. Lifespan is another matter and it's debatable what, if anything, extends it. But at least one can die trying, right.

BTW, not everyone, or even the majority is vegan. And I personally don't think it's "extreme" in any way. Frankly, to me obesity is extreme. Or obsessing if one's wine is from the right parcel, year, or at the perfect temperature. Different people, different strokes.

I am vegan for moral reasons, not health ones. To me, the word is perceived by each sentient creature only while there is sentience to perceive it. Thus there is a world that is "unique" to each sentient person or animal, and it begins and ends with such an individual. I simply decided that I did not want the world of an animal to be snuffed out because of me.

Any health benefits (and I am convinced that there are such) from being a vegan stem from that decision. But I don't have to, and wouldn't eat animals, even if it was proven to be healthy.

OK, this is it for my rant.

I liked your answers. I know it’s a hobby and my hobby is to question beliefs and critically look at them.

And for me as far as eating animals, I don’t really have a problem with it. If it makes me feel good and it’s legal to eat, then I will eat it.

I’m not really into eating meat. I like pizza, peanut butter and jelly with banana and a glass of non fat or 1% milk. I also eat eggs and almonds.....(not together), necessarily.

Carry on,

DHL

 

 

 

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Plants are alive too.  When you eat a plant, you're consuming a living creature.

Unlike chlorophyll bearing plants, animals (including humans) are unable to create the food that they eat.  So all animals are parasites on other living creatures, whether plants, animals and/or fungi.

  -- Saul

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17 hours ago, DHL said:

I know it’s a hobby and my hobby is to question beliefs and critically look at them.

Fair enough. But at some point, you must detect a pattern that appears beneficial to health, and it is reasonable to act on it. Essentially, most of us hear do just that.

 

3 hours ago, Saul said:

When you eat a plant, you're consuming a living creature.

Unlike chlorophyll bearing plants, animals (including humans) are unable to create the food that they eat.  So all animals are parasites on other living creatures, whether plants, animals and/or fungi.

Of course, Saul. But I noted sentience above.

A cow or a chicken is just as capable of comprehending and fearing death as you and I are. I simply do not want to be responsible for their deaths and the snuffing out of their worlds. There is no evidence that I have seen that suggests sufficient sentience in any plant.

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